Endoscopic vs open spine surgery for L1-5 stenosis and spondylosis?

@rockinrene65 - welcome to Mayo Clinic Connect. I'm sorry your pain is horrific. Sounds exceedingly hard.

Glad you've connected with @jenatsky. Hoping others in this discussion will also have ideas for you on how to manage the pain short- and long-term, such as @cjr14 and @marietter. If you've not already met @jenniferhunter, I'd like for you to meet her, too.

A couple of other support groups on Mayo Clinic Connect you may consider following, due to the conditions you have and mentioned, are:

- Blood Cancers & Disorders Support Group https://connect.mayoclinic.org/group/blood-cancers-disorders/, and especially this discussion in that group:
- Adult Langerhans cell Histiocytosis and CMML https://connect.mayoclinic.org/discussion/adult-langerhans-cell-histiocytosis-and-cmml/

- Diabetes & Endocrine System Support Group https://connect.mayoclinic.org/group/diabetes-and-endocrine-problems/

When you said you are seeing your neuro Friday, I believe you are talking about a neurosurgeon, but you also could be talking about a neurologist? Will you let us know? Do you have some questions written down that you want to ask him or her at that appointment?

I would be interested in hearing what people have to say about this also. I just had an open lumbar decompression of L4-5, L5-S1 for central canal stenosis and bilateral medial facetectomy at both levels as well as a Microdissection. I was having debilitating nerve pain in my left glute, all the way down my leg to include my ankle, foot and toes with numbness and my skin was so sensitive at times that I couldn’t even touch it. I was not able to stand or walk for more than 30 seconds before the pain became so intense I had to sit or lie down.

2 weeks post surgery, I would say ~90% of the pain is gone. I don’t want to jinx myself, because I know it’s early in the recovery but I am hopeful. Long story, a friend had similar symptoms (maybe not as debilitating) and he had a minimally invasive laminectomy the week before me. I would like to know the specifics around choosing one over the other, the M-A surgery obviously is a less extensive process and quicker recovery.

@rockinrene65 you didn’t say what pain meds you’re taking or how long you’ve been on them? No you shouldn’t be in intractable pain. After my 1988 fusion and laminectomy I was put on Tylenol #4 and eventually #3’s for over 10 years. I was switched to morphine pills and after a few years on that I went to a time-release morphine pill. This eventually stopped working sufficiently for my pain relief. I’ve been on buprenorphine patch which provides 24/7 relief. I went from 15mcg patch every 7 days to 20mcg after a 2 week trial. I’ve been on that same dose for about 5 years with good results. But with your comorbid conditions I don’t know if you can use it.
I can totally understand how you feel and why you feel this way. Chronic pain is very debilitating and it takes a lot out of you. I find that stretching, exercise helps my pain relief as does walking which I do every day.
Have you tried acupuncture, Myofascial release, mindfulness therapy? I’m doing all of these because I don’t want to take any breakthrough meds. I also micro dose THC and CBD 3 times a day. You need to investigate a few methods to help yourself be pain free and thinking outside the box helps. I hope the neurologist can help explain thing’s further? You might ask what is stopping them from performing the MILD procedure too,

Hi,
Wow...im sorry to read you've still go so much pain & having to take more & more Norco, remember to be careful to take Tylenol per normal recommend dosages, any amt over 4gm (aka 4000mg) is too much & can cause liver damage & ideally stay below that amt & of course, always per your physician's instructions.
Perhaps, unless you've already done this, I might consider a 2nd opinion. Seems like there's something there, clearly, thats causing so much pain!
Also, be careful w/ what you do w/ physically using your back & taking your pain meds, bc when taking pain meds you may feel a little better than you actually are & then tend to overdo it a bit
Good luck 🙏

@mkk0124
Thank you I totally get that!, I fell crouching down to reach in my frig 4 months ago and lost my balance bringing a gallon of water out from the back bottom shelf, next day my ribs hurt so bad, Went to ER and they found a small fracture ...crazy ~ with the prednisone and 2 diuretics for my LCH and then the low dose Norco seem to all cause osteo so catch 22,..My lch caused the type 2 diabetes as well and I am on 54 units insulin now as well.
I am riding my stationary bike about 3 minutes every other day to strengthen my core as told, and I am to increase that once it feels better...I was at 15 mins Treadmill then 15 mins Bike a day just a year ago... lost 22 lbs and felt great.
Suffering this back issue, this time, now a full year and Norco has been such a help! When my cortisone/lumbar shots quit working as well or as long, Doc put me on Norco 5mg.
Original assault {lol} in 2018 I slipped on snow holding to many bags of groceries in each hand, trying to save them I went down and tried to catch myself and felt a "pop" But the next morning I could not raise my arms nor move at all, Screaming! I called 911...
Now at 60 I have to pay even more attention, frailties ugh.

@rockinrene65
I am sorry about your pain, I undertand the ability not to stand long.
You mentioned you were going to see a neuro.
Did you get a diognosis of the pain generator?

@jlssurplus

pain generator?

@rockinrene65
Sorry, what in your back is causing the pain?

@jlssurplus
Severe Spinal Stenosis- Narrowing.
Herniated disc L5 7mm
Disc Degeneration